Insulin Glargine

Insulin, Long-acting insulin analog, Basal insulin

Insulin glargine

Lantus, Basaglar, Semglee, Toujeo (U-300)

Experience

👥 No personal reports yet

⚕ No clinical reports yet

Log in to add your own experience.

Problems

No problems yet. Be the first to suggest one.

+ Add a problem

Titration strategies

No titration strategies yet. Be the first to suggest one.

+ Add a titration strategy

Effects

No effects listed yet. Be the first to suggest one.

+ Add an effect

Relevant anecdote

No anecdotes yet. Share a relevant one.

+ Add an anecdote

Relevant Literature

No literature entries yet.

Log in to submit relevant literature.

Summary

Classes

Insulin, Long-acting insulin analog, Basal insulin

Common uses

Type 1 diabetes mellitus▲0▼, Type 2 diabetes basal coverage▲0▼

Pharmacy

Starting dose

~10 units SC at the same time daily, or 0.1-0.2 units/kg/d; titrate by fasting glucose

Preparations

100 U/mL (Lantus, Basaglar, Semglee) vials and pens; 300 U/mL (Toujeo) pens

US FDA Max

Titrated to glucose; no fixed ceiling

Pharmacology

Routes

Subcutaneous (never IV; not for use in insulin pumps)

Onset

1-2 hours

Duration

~24 hours per dose (peakless profile by design)

Half-life

~12 hours apparent (functional duration ~24 hours due to depot release kinetics)

Bioavailability

~100% from subcutaneous depot (by definition of the route)

Pregnancy

Insulin is the preferred glucose-lowering therapy in pregnancy; glargine has reassuring observational data, though NPH and detemir remain the traditional choices.^{[citation needed]}

Legal status

Rx-only in US

Purported mechanism

Insulin glargine is a recombinant human insulin analog (Gly-A21, two added Arg residues at B-chain C-terminus) that precipitates as microcrystals at physiologic pH after injection from its acidic formulation, producing slow continuous redissolution and a near-peakless 24-hour basal insulin profile.▲0▼ Binds the same insulin receptor as endogenous insulin with comparable mitogenic-to-metabolic ratio; provides basal hepatic glucose suppression and peripheral glucose uptake without prandial peaks.